Application Form

We are delighted to open our online application system. We plan to welcome our first family on Saturday 6th August. Please complete the details below and select your preferred 1st, 2nd and 3rd choice dates. All holidays will be offered on a first come first served basis.

We look forward to welcoming you to stay at Eilidh Brown’s.

Preferred Date (Bookings run Sat-Fri). Alternative Date 1 Alternative Date 2 Primary Care Giver Child's Name Amount of Children Staying Child 1 Age Child 2 Age Child 3 Age Child 4 Age Are they Currently Undergoing Active Treatment? If No, When Did They Receive Their Last Treatment? Consultant Nurse Do You Agree To The Terms & Conditions? Yes, I Accept The Terms & Conditions Keeping In Touch Please let us know how you wish to be contacted, you can change this at any time. Likewise, please do let us know if your contact details change. If you change your mind about any of these choices or have any concerns about any communications from us, please contact info@eilidbrown.co.uk. Your information will be held securely and confidentially in line with our Privacy Policy, available at www.eilidhbrown.co.uk/privacypolicy. I am happy for my data to be used to contact me about: (tick all that apply) The latest email newsletter from The Eilidh Brown Memorial FundFundraising and social eventsEilidh Brown House Holiday Bookings (for children with cancer and their families) I am happy to be contacted via: (tick all that apply) EmailPostTelephoneText MessageSocial Media